Implantation of bioresorbable vascular scaffolds following acute coronary syndrome is associated with reduced early neointimal growth and strut coverage

Joel P. Giblett, Adam J. Brown, Harry Keevil, Catherine Jaworski, Stephen P. Hoole, Nick E.J. West

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6 Citations (Scopus)

Abstract

Aims: Registry data have suggested higher than anticipated rates of scaffold thrombosis following bioresorbable vascular scaffold (BVS) implantation. We examined early neointimal growth and strut coverage in BVS to ascertain whether this was affected by clinical presentation. Methods and results: Patients undergoing optical coherence tomography (OCT)-guided BVS implantation, either for stable angina (SA) or acute coronary syndrome (ACS), were recruited to this observational study. Repeat OCT was performed at follow-up (median 74 days), and scaffolds analysed at 1 mm longitudinal intervals for scaffold/flow area, scaffold apposition, neointimal growth and strut coverage. Twentynine BVS were included in the analysis (62% implanted following ACS). There were no differences in baseline patient/lesion characteristics. All BVS achieved >90% predicted scaffold area with only 1.64% of struts classified as incompletely apposed, compared with 0.47% at follow-up (p=0.006). Reductions in mean scaffold (-4.0%, p=0.01) and flow (-8.4%, p<0.001) areas were observed at follow-up, with larger reductions in mean flow area in stable patients (-14.5±14.2 vs.-4.9±7.9%, p=0.03). ACS patients had reduced neointimal growth (0.51±0.18 vs. 0.87±0.37 mm2, p=0.002), and increased percentage of uncovered struts (2.68±1.67 vs. 1.43±0.87%, p=0.015). Conclusions: Early neointimal growth and strut coverage are reduced following ACS in patients receiving BVS. These results may, in part, explain the high rates of ST in registry data.

Original languageEnglish
Pages (from-to)724-733
Number of pages10
JournalEuroIntervention
Volume12
Issue number6
DOIs
Publication statusPublished - 1 Aug 2016
Externally publishedYes

Keywords

  • Acute coronary syndrome
  • Bioresorbable vascular scaffold
  • Drug-eluting stent
  • Neointimal growth
  • Ptical coherence tomography
  • Stent thrombosis

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